Provider Demographics
NPI:1356571368
Name:IGLESIA, YEHUDIT (L AC)
Entity type:Individual
Prefix:MRS
First Name:YEHUDIT
Middle Name:
Last Name:IGLESIA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 AVENTURA BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3109
Mailing Address - Country:US
Mailing Address - Phone:305-949-9828
Mailing Address - Fax:786-253-3829
Practice Address - Street 1:2925 AVENTURA BLVD STE 306
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-3109
Practice Address - Country:US
Practice Address - Phone:305-949-9828
Practice Address - Fax:786-253-3829
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2699171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist